Comparing the effectiveness of online individualized transdiagnostic treatment with acceptance and commitment therapy on medication adherence, gastrointestinal symptoms and perceived stress of patients with irritable bowel syndrome.

Homa Shahkaram, Amir Sadeghi, Abbas Masjedi Arani, Maryam Bakhtiari, Amir Sam Kianimoghadam
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Abstract

Aim: This study aimed to investigate whether transdiagnostic treatment as well as acceptance and commitment therapy (ACT) could improve treatment adherence and alleviate gastrointestinal symptoms plus perceived stress in patients suffering from irritable bowel syndrome.

Background: Research has shown that people with chronic diseases often have negative attitudes toward medications, especially when they also have psychiatric disorders. This, along with the complex dosing requirements and inadequate knowledge about medication adherence among irritable bowel syndrome patients, can affect the treatment efficacy.

Methods: A randomized clinical trial was conducted using a pre-test-post-test design. The statistical population included patients with irritable bowel syndrome referring to Taleghani Hospital in Tehran between winter 2021 and spring 2022. Convenience sampling was used to select 30 individuals, with 15 people assigned to each group. Two types of psychotherapy were provided online and individually to the participants. The desired treatments were given to the transdiagnostic treatment and ACT groups in eight weekly sessions of 45-60 minutes.

Results: There was no significant difference between the transdiagnostic treatment pre-test and ACT regarding perceived stress, medication adherence, and gastrointestinal symptoms (P>0.05). There was no significant difference either between the transdiagnostic treatment and ACT post-test. However, there was a significant difference between the pre-test and post-test phases of ACT regarding adherence, gastrointestinal symptoms, plus perceived stress (P<0.05) and transdiagnostic treatment regarding gastrointestinal symptoms (P<0.05).

Conclusion: Specialists may use transdiagnostic treatment and ACT as effective psychological treatments to alleviate gastrointestinal symptoms and perceived stress, thereby increasing treatment adherence in patients with irritable bowel syndrome.

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比较在线个体化跨诊断治疗与接受和承诺疗法对肠易激综合征患者服药依从性、胃肠道症状和感知压力的效果。
目的:本研究旨在探讨跨诊断治疗以及接纳与承诺疗法(ACT)能否改善肠易激综合征患者的治疗依从性,并减轻肠易激综合征患者的胃肠道症状和感知压力:研究表明,慢性病患者通常对药物治疗持消极态度,尤其是同时患有精神疾病的患者。这一点,再加上肠易激综合征患者复杂的用药要求和对药物依从性的认识不足,都会影响治疗效果:方法:采用前测-后测设计进行了一项随机临床试验。统计人群包括 2021 年冬季至 2022 年春季在德黑兰 Taleghani 医院就诊的肠易激综合征患者。研究采用便利抽样法选出 30 人,每组 15 人。为参与者提供了两种在线和单独的心理治疗。对跨诊断治疗组和 ACT 组进行了所需的治疗,每周 8 次,每次 45-60 分钟:结果:在感知压力、服药依从性和胃肠道症状方面,转诊断治疗前测试组和 ACT 组之间没有明显差异(P>0.05)。经诊断治疗和 ACT 后测试之间也没有明显差异。然而,ACT 测试前和测试后阶段在依从性、胃肠道症状和感知压力方面存在显著差异(P结论:专科医生可将跨诊断治疗和 ACT 作为有效的心理治疗方法,以减轻肠易激综合征患者的胃肠道症状和感知压力,从而提高他们的治疗依从性。
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